How Do Insurance Companies Decide How Much To Offer?

Insurance providers may pay their policyholders when they submit a valid claim following an accident. They may also pay accident victims on behalf of an at-fault party in personal injury cases. Find out how an insurance company decides a settlement offer in personal injury cases. 

The Claim Undergoes an Adjuster Review

Insurance companies cannot assign just any random value to a claim before making a settlement offer. The claim valuation process can be quite thorough. An insurance adjuster reviews details within the claim, including:

• Photos of the accident scene
• Description of the injury or property damage
• Estimated medical expenses related to the injury  

They’ll also investigate the claim further and collect evidence to substantiate it, such as the claimant’s medical records. This information typically helps the adjuster determine the total economic damages. 

During their review, the adjuster also conducts a liability assessment for fault determination. Their findings can significantly impact the final settlement, especially in states like New York that follow pure comparative negligence laws. Claimants who are partially at fault in an accident will miss out on a portion of their accepted offer, as determined by their fault percentage. 

Insurers Calculate Damages for a Victim’s Pain and Suffering

Claimants often wonder how an insurance company decides on a settlement offer that includes economic and non-economic damages. They can tally up a sum of all measured economic damages, such as lost income, property damage estimates, and medical expenses. However, to account for non-economic damages, they may use a formula known as the multiplier method. 

This involves the following steps:

1. Adding together economic damages: This figure will be a key component in the calculation. 
2. Assessing the severity and impact of one’s injuries: Insurers evaluate factors like long-term care requirements or permanent disability. 
3. Assigning a multiplier value: Based on the severity of the injuries, insurance companies typically assign claimants a value ranging from 1.5 to 5.0. Serious injuries with long-term effects tend to garner higher multiplier values. 
4. Calculating a settlement offer using the multiplier and economic damages: Professionals take the sum of economic damages and multiply it by the assigned multiplier. 

Say someone is in a minor car accident and incurs $20,000 in economic damages. If they’re expected to make a full recovery from their injuries, the at-fault party’s insurance company may assign them a multiplier of 1.5. Their settlement offer would be $30,000 after multiplying the two figures. 

Lawyers Know How Insurance Companies Decide Settlement Offers and Negotiate for Claimants

Insurance adjusters review the evidence in each claim to determine its probable worth. However, claimants may receive a low-ball offer. Insurers could use this tactic in an effort to settle the claim quickly. 

Personal injury attorneys understand this tactic and can negotiate with the insurance provider on behalf of their client. Legal professionals also perform their own investigation and gather evidence supporting the victim’s claim. If they believe the case is worth more than the initial offer, they’ll present evidence to the insurance company and propose a higher settlement. 

In addition, lawyers can assist claimants with tips immediately after an accident and, if necessary, file a lawsuit. 

Consult a Personal Injury Attorney for Assistance With Your Claim

Knowing how an insurance company decides a settlement offer can make the claims process less confusing. If an insurer denies your claim because it exceeds policy limits or you want to negotiate another offer, seek legal help. Cantor, Wolff, Nicastro & Hall LLC handles personal injury claims for accident victims throughout the Buffalo area. 

Contact us online or call 716-848-8000 to request a legal consultation.

FREQUENTLY ASKED QUESTIONS (FAQ): 

Q: How do insurance companies calculate pain and suffering?

A: Insurers often use a multiplier method, where economic damages are multiplied by a value (1.5 to 5.0) based on the severity of injuries.

Q: What factors do insurance adjusters consider when reviewing a claim?

A: Adjusters review photos, injury descriptions, and medical expenses, and conduct a liability assessment for fault determination.

Q: Can I negotiate a settlement offer from an insurance company?

A: Yes, claimants can negotiate, especially with the help of a personal injury attorney who can present evidence and propose a higher settlement.